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The Commissioning Academy Framework Document – An Introduction to Commissioning. Contents. About this document 3 What is commissioning 4/5 What’s different 6 What is not commissioning 7/8 What makes up an excellent commissioning process 9/10 Why no models 11
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The Commissioning AcademyFramework Document – An Introduction to Commissioning
Contents About this document 3 What is commissioning 4/5 What’s different 6 What is not commissioning 7/8 What makes up an excellent commissioning process 9/10 Why no models 11 The Challenge 12 Glossary of terms 13 Acknowledgements 14 2
About this document The Commissioning Academy aims to encourage and support public sector leaders to understand their citizens and communities; and work more effectively in order to secure better outcomes. This document explains what the Academy believes commissioning to be all about. Much has, and will continue, to be written about commissioning. This document is not intended to act as a comprehensive guide to commissioning. It seeks to be a framework to be used by delegates of the Academy programme with the content expanded upon during the nine-days. The aim is to provide an easy-read, high level summary which seeks to stimulate your ambition to grasp this opportunity to improve lives.
What is commissioning? • Put simply, we “commission” in order to achieve outcomes for our citizens, communities and society as a whole; based on knowing their needs, wants, aspirations and experience. • We are advocating an integrated approach to better understanding citizens and communities and using this insight to work more effectively in order to secure better outcomes and allocate resources. This approach also acknowledges the whole-system and interdependencies between citizens, communities, organisations and services. • Strong, ambitious and visionary leaders are essential to securing better outcomes. The economic climate is forcing change but our residents and communities have also changed. Commissioning allows us to embed democracy at every stage, not just setting the strategic direction, but to rebalance the contribution from public services, communities and citizens to improving outcomes. Is not about delivering more of the same for less. We are advocating a fundamental change in mind-set. 7. There is a plethora of commissioning models that exist and we have adopted an approach based on key stages. Whilst there is no single approach to commissioning, there does need to be a consistent rigour to the activities undertaken. 4
What is commissioning? 8. Commissioning can occur in many different ways: at strategic or operational level; covering different geographical areas; or address the needs of groups of people (e.g. young adults with learning disabilities) or a family or an individual. Regardless of the level, the focus should be on commissioning FOR outcomes rather than simple commissioning OF services. 5
What’s different? What makes commissioning now different from before? 9. There is a collective will across the public sector, nationally and locally, to do things differently. If all elements of commissioning are implemented, commissioning has the ability to transform, improve and redefine the relationship between the public sector/ individuals/communities and ultimately improve outcomes. 10. With significant changes to the public sector landscape, commissioning provides opportunities to change where the power lies. This could be between commissioners, providers, service users or the community. 11. The challenges to public funding mean transforming the delivery of our public services is more important than ever; joint commissioning, fostering innovation, systems thinking, co-production and co-design with service users are key to finding greater efficiencies and better productivity. 12. The ability of commissioners to proactively influence the market in order to meet residents needs is recognised. Expertise is growing in market management, as well as de-commissioning and dis-investment and the transition to new models of provision.
What is not commissioning? It’s not – all about the cash • We operate in a complex public services environment. With different sectors and organisations focused on providing different aspects of support to individuals and communities. Securing better outcomes relies on a mix of activities from a range of sectors. Supporting a ‘troubled family’, for example, will involve the resources and assets of a vast range of agencies (public, voluntary and private), the local community and buy-in from the family themselves. Very often therefore we are seeking to influence others through our commissioning, as well as commission direct. It’s not – all about procurement • A lot of time is currently spent deliberating delivery models, procurement strategies and contracting rules and regulations. These are important but commissioning is much wider. As much time as possible should be spent on agreeing the question to be answered, understanding the customer and devising appropriate outcomes. There are many ‘commissioning levers’ available outside of procurement including: • Devolving commissioning to communities or individuals • Influencing others to deliver the outcomes • Influence via grants • Influence via changes in rules, regulations and practices • Transferring funding for others to deliver • Procure but full or part-cost recover via charging • Decommissioning • Manage demand through the use of information, advice and guidance, behaviour change • Use of mutuals, social enterprises, etc. where outcomes are met using internal resources
What is not commissioning? It’s not – all about outsourcing • The activities required to improve outcomes should be delivered by the best placed individual or organisation at the best price. By involving key stakeholders in the design stage - current and potential service users, staff, potential providers – you can be confident that you are commissioning what will have the most impact and this will inform the commissioning specification. This does not automatically mean an external provider. 8
What makes up an excellent commissioning process? We believe excellent commissioning is made up of the following stages: • What’s the question? • Get to know and work with your customers • Define the outcome and priorities • What will it look like? • How will you get there? • Measuring the impact Stage 1 - What’s the question? • Essential to successful commissioning is being very clear what the question is that needs answering. For example: what’s important to young people in our local area; how can we help older people stay independent?, how do we promote recovery for drug and alcohol abusing offenders?, what is our vision for under 5s?, how do we increase the skills base in our locality? More time spent at this stage will increase the chances of success later on. Stage 2 - Get to know and work with your customers • Whilst insight is critical at every stage, this is where it really matters. This stage focuses on finding out as much as you can about your customer group – their needs, wants, aspirations, experiences. Evidence sources can include surveys, community engagement, demographics, Customer Relationship Management (CRM) systems, social trend data. Be creative to ensure that you seek out and listen to all, not just existing service users and those that shout loudest. This is not just a dialogue, think co-design and co-production.
What makes up an excellent commissioning process? Stage 6 - Measuring the impact • Effective performance management appropriate to the commissioning strategy is essential to know outcomes are being improved. Customer experience and feedback should be part of the measures. Commissioning for transformation and improvement demands significant change to established thinking and practice, this will be reflected in the plans and how performance is measured. Stage 3 - Define the outcome and priorities Resources are scarce so we need to define the outcome(s) we are seeking to achieve and how this fits in with competing priorities. The agreed outcome and priorities must directly answer the question, reflects the insight and be deliverable within the available resources. Continuous engagement and dialogue (co-production) should be used to test and refine. Stage 4 - What will it look like? Here we start to define what is needed to achieve the outcomes. It must focus on outcomes not existing services, for example cheap transport for young people to get around independently for social and work needs. Continue to find creative ways to engage and involve key stakeholders to co-produce radical solutions. Working within the resources available, options could involve creating, developing and influencing markets or redesign to best achieve a balance of cost, health, social, economic, and environmental benefits. Stage 5 - How will you get there? This action planning stage needs to take account of where you are now and what is needed to achieve the vision. This could involve some short-term actions, as well as medium to long term plans such as developing the market. Remember commissioning is wider than a single organisation and there will typically be a “mixed economy” of providers of services; consider innovative approaches to meet the increasing demands, choice and expectations on public services. 10
Why no models? • You may have expected a commissioning model to be included in a framework document. We have chosen not to include for a number of reasons: • what makes up excellent commissioning is already set out in this document as stages. • no one model was adequately flexible or sophisticated to be usefully applied to the vast range of questions being answered. • how you apply each stage of any cycle will depend on the scale and complexity of what is being done. • there are already so many out there! Go out and find out that suits….
The challenge This is a time of opportunity. A time to redefine the relationship between the public sector, provider organisations (private, public and voluntary), individuals and their communities. The importance of grasping this opportunity is reflected in the investment the Cabinet Office is making into the Commissioning Academy programme. Commissioning provides a route to deliver the radical change needed. Success is depended on strategic leaders within the public sector nationally and locally believing that understanding customers will ensure the right support and services are commissioned to improve outcomes. Transformation of culture, mind-set, systems and processes is not easy. We operate in a complex environment where organisational and professional boundaries must now be removed. The programme aims to stimulate your ambition and capture hearts and minds to the potential to maximise all our resources. Our aim is to deliver a formidable network of 2000 outcome focused leaders. 12
Glossary of Terms Sources: LGA’s “Guide to Commissioning for maximum value”
Acknowledgements Commissioning Academy Pilot 1: • Delegates in particular Eric Robinson, Jacqui McKinlay, Aliko Ahmed and Craig Derry for their editorial input • Contributors and delivery partners throughout the programme for their ideas and stimulus • Site visit hosts • Cabinet Office Academy Team East Sussex County Council Oldham Metropolitan Borough Council LGA 14